The present invention relates to pulmonary therapy apparatus and, more particularly, to chest compression and proning devices which provide pulmonary therapy on a patient. Moreover, the present invention relates to a pulmonary therapy apparatus which incorporates one or more of the following components: a proning apparatus, a chest compression or binding apparatus, an oscillating motion therapy apparatus and a longitudinal rotation therapy apparatus.
The positioning of patients in a prone position (i.e., face down) typically results in improved oxygenation to the patient as opposed to a supine position (i.e., face up). More particularly, it is believed that prone positioning reduces the occurrence of acute respiratory distress syndrome (ARDS). ARDS historically has had a mortality rate often exceeding sixty percent. Additionally, bed ridden patients with diseases or infirmities not necessarily requiring improved oxygenation often require that they be rotated between supine and prone positions in order to avoid the formation of bed sores.
Traditionally, the re-positioning and, moreover, the turning of patients about their longitudinal axes, has been accomplished only with considerable effort. The turning of patients from a supine position to a prone position often requires assistance from at least three caregivers. Additionally, patients often have a plurality of tubes and lines connected to their bodies for a variety of medical reasons, including intravenous supply and ventilation. The turning process is often further complicated by intermingling or tangling of the tubes or lines.
In short, proning has proven to be an effective intervention to increase oxygenation in the ARDS patient. Ease in attaining the prone position obviously facilitates its utilization. As such, there remains a need for a prone positioning apparatus which reduces the manual labor required, increases caregiver efficiency, and improves line management.
It is also believed that chest binding or compression may prove to be an effective method of pulmonary therapy and, more particularly, alveolar recruitment. It is believed that chest binding through the application of force on the upper chest of a patient, who is supplied air through a conventional ventilator, will prevent over-extension of the upper portion of the lungs and force the ventilated air to the lower portion of the lungs. As such, a patient will receive more effective oxygenation through the ventilator. Therefore, there is a need for a chest binding device for facilitating ventilation of distant lung areas.
Another method of pulmonary therapy for improving oxygenation to a patient is through oscillating motion therapy and, moreover, through longitudinal rotation therapy. In essence, it is believed that oscillating rotational motion of a patient support surface for periodically moving a patient from a substantially upright position to a substantially horizontal position improves breathing and, therefore, oxygenation to the patient. It is further believed that placing the body in a weightless neutral body position, commonly referred to as a xe2x80x9czero gravityxe2x80x9d position, optimizes such therapy. Therefore, there is a need for a longitudinal rotation apparatus which facilitates improved ventilation and lung drainage.
In an illustrated embodiment of the present invention, a proning apparatus comprises a base including a head portion, a leg portion, and a body portion positioned intermediate the head portion and the leg portion. The base further includes an opposing pair of longitudinal side edges, a patient support surface extending between the side edges, and a longitudinal axis. A face-receiving aperture is formed within the head portion and is adapted to receive a face of a patient therein. An abdomen-receiving aperture is formed within the body portion in longitudinally spaced relation to the face-receiving aperture, the abdomen-receiving aperture being adapted to expose the abdomen of a patient when the face is in the face-receiving aperture. A groin-receiving aperture is formed within the leg portion in longitudinally spaced relation to the abdomen-receiving aperture, wherein the groin-receiving aperture is adapted to expose the groin of the patient when the face is in the face-receiving aperture.
A plurality of supports are coupled to the patient surface of the base. The plurality of supports include at least one head support cushion coupled to the head portion, at least one shoulder support cushion coupled to the body portion, and at least one leg support cushion coupled to the leg portion. The plurality of supports further include at least one hip support cushion positioned intermediate the abdomen-receiving aperture and the groin-receiving aperture. A plurality of line management devices are supported by the base adjacent to the side edges, wherein the line management devices configured to releasably secure hoses and lines adjacent the base. A plurality of straps are coupled to the base adjacent one of the side edges, each of the straps including a padded section adapted for engaging the patient.
In another illustrated embodiment of the invention, a proning therapy sleeve comprises a bottom support portion including a head end and a foot end, the bottom support portion configured to be located on a mattress of a bed. A pair of opposing side portions extend outwardly from the bottom support portion. An aperture is formed in each of the pair of opposing side portions, wherein the aperture is configured to receive the arms of a patient. A head support bladder is supported in each of the side portions. At least one inflatable chest support bladder is supported in each of the side portions in spaced relation to the head support bladder. A thigh-engaging bladder is supported in each of the side portions in spaced relation to the at least one inflatable chest support bladder. A calf engaging bladder is supported in each of the side portions in spaced relation to the thigh engaging bladder.
At least one line management apparatus is supported proximate at least one of the head end and the foot end of the bottom support portion, wherein the at least one line management apparatus is configured to releasably secure hoses and lines extending to the patient. A plurality of first fasteners are supported by the first side portion and a plurality of second fasteners are supported by the second side portion wherein the first and second side portions are foldable over the front of the patient and the fasteners are connected to secure the sleeve about the patient.
The bladders are provided for support of the patient in the prone position. Additionally, the bladders may be utilized to provide therapy to the patient. More particularly, the at least one chest bladder may be inflated to provide chest binding or compression when a ventilator is used to supply air or oxygen to the patient through a ventilator tube. As air is blown into the patient""s lungs through the ventilator tube, the at least one chest bladder is inflated to force air downwardly into the patient""s lungs.
The bottom support surface may include a plurality of apertures forming an air zone and coupled to an air supply. When air is supplied to the air zone, the air is forced outwardly through the holes to provide an air pallet or bearing to assist in rotational movement of the patient. Additionally, the side portions may each include an outer bladder coupled to the air supply. An outer surface of the side portions include a plurality of apertures so that air flows outwardly through the outer surface for providing an air pallet or bearing. As such, the entire outer circumference of the sleeve may be provided with an air bearing to facilitate the proning of the patient.
In yet another illustrated embodiment of the present invention, a proning apparatus comprises a bottom support bladder including opposing first and second sides, an outer surface, an air chamber, and a plurality of apertures formed within the outer surface and in fluid communication with the air chamber. A plurality of side flaps include a first end coupled to the bottom support bladder proximate the first side. A plurality of fasteners are supported by the second ends of the side flaps and are releasably secured proximate the second side of the bottom support bladder. The plurality of side flaps include a first head flap coupled to the bottom support bladder proximate the first side and a second head flap coupled to the bottom support bladder proximate the second side. A head bladder is connected to each of the first and second head flaps. The side flaps further include a chest support flap supporting a plurality of chest support bladders. A bottom prone bladder is positioned to alternatively support the bottom support bladder and the plurality of side flaps. The bottom prone bladder is configured to be inflated with air when it is supporting the plurality of side flaps.
In a further illustrated embodiment of the present invention, a patient support includes a base, an inner frame supported by the base, a plurality of rollers rotatably supported by the inner frame, and a movable outer frame defining a longitudinal axis and a transverse axis. The outer frame is supported by the inner frame for longitudinal movement relative thereto. A patient support surface is supported by the outer frame, and a drive mechanism is operably connected to the movable outer frame for driving the outer frame in motion. A coupling is provided intermediate the base and the inner frame for facilitating rotation of the outer frame about the longitudinal axis and the transverse axis. A massage mechanism is supported adjacent the patient support surface. The massage mechanism includes a plurality of rollers configured to move vertically relative to the patient support surface.
In still another illustrative embodiment of the present invention, a pulmonary therapy system comprises a chest binding apparel apparatus including a plurality of air bladders and configured to be supported proximate the chest of the patient. An air supply is in fluid communication with the plurality of air bladders and is operably connected to a controller. A ventilator supplies air to the lungs of the patient and is coupled to a ventilator pressure sensor for sensing a pressure of air supplied to the patient and generating a ventilator pressure signal indicative thereof. The ventilator pressure sensor is in communication with the controller for supplying the ventilator pressure signal thereto. The controller controls air flow to the plurality of air bladders in response to the ventilator pressure signal. An apparel pressure sensor is coupled to the binding apparel apparatus for sensing a pressure applied by the binding apparel apparatus to the chest of the patient and generating an apparel pressure signal indicative thereof. The apparel pressure sensor is in communication with the controller for supplying the apparel pressure signal thereto.
A switching valve is coupled to the air supply for alternating between a first mode of operation wherein air is supplied to the air bladders and a second mode of operation wherein air is evacuated from the air bladders. An exhaust line is coupled to the switching valve for exhausting evacuated air from the air bladders to atmosphere. A bladder supply line is provided for supplying air from the air supply to the air bladders. The switching valve alternatively connects the air supply to the exhaust line and the bladder supply line.
The chest binding apparel apparatus includes a vest having a front portion, a rear portion and a head receiving aperture intermediate the front portion and the rear portion. At least one front bladder is supported by the front portion and at least one rear air bladder is supported by the rear portion. The front portion and the rear portion preferably include a substantially rigid shell wherein the at least one front air bladder and the at least one rear air bladder are supported either on an inner surface of the shell or an outer surface of the shell depending upon the desired functionality. The at least one front bladder and the at least one rear bladder each include a plurality of independently inflatable pressure zones.
In a further illustrated embodiment of the present invention, a longitudinal rotation therapy method comprises the steps of supporting a patient on a patient support surface including a head section, a back section, a seat section, and a leg section, the patient support surface further including a longitudinal axis and a transverse axis. The method further comprises the steps of positioning the head section upwardly relative to the back section, positioning the back section upwardly relative to the seat section, and positioning the leg section downwardly relative to the seat section. The method further includes the steps of rotating the patient support surface about the transverse axis in a first direction, stopping rotation of the patient support surface upon reaching a first limit, rotating the patient support surface about the transverse axis in a second direction opposite the first direction, stopping rotation of the patient support surface upon reaching a second limit, and repeating the rotating and stopping steps, thereby providing oscillating rotational movement to the patient support surface. The positioning steps comprise the steps of placing the patient in a weightless, neutral body, or zero gravity, position.
In another illustrative embodiment of the present invention, a proning apparatus includes a frame, a patient support supported by the frame and including a head end and a foot end, the patient support defining a longitudinal axis. A first upright extends substantially vertical and is positioned proximate the head end, and a second upright extends substantially vertical and is positioned proximate the foot end. A movable support member is rotatably supported intermediate the first and second uprights. A wrap is supported for movement by the movable support member, the wrap including first and second longitudinally extending side edges defining an access opening therebetween and configured to receive a patient in a set up mode of operation, and to close the access opening in a turning mode of operation. A drive mechanism is coupled to the movable support member for rotating the movable support member and the wrap.
In still another illustrative embodiment of the present invention, a proning apparatus comprises a patient support surface extending between opposing first and second side edges, the patient support surface including a head end and a foot end and defining a longitudinal axis. A first drive support member is positioned proximate the head end and a second drive support member is positioned proximate the foot end. A drive mechanism is supported by the first and second drive support members. A sleeve support member is coupled to the drive mechanism for lateral movement above the patient support surface. A sleeve is supported by the support member, the sleeve including an inner surface configured to contain a patient and an outer surface configured to engage the patient support surface. A guide member is provided for guiding movement of the support member upwardly from proximate the first side edge, transversely above the patient support surface and downwardly to proximate the second side edge.
In a further illustrative embodiment of the present invention, a proning apparatus comprises a frame, a patient support supported by the frame and extending between first and second sides, the patient support including a head end and foot end and defining a longitudinal axis. A first upright is positioned proximate the head end and a second upright is positioned proximate the foot end. A support member is coupled to the first and second uprights and is positioned above the patient support surface. A sheet is secured to the support member and a pulling device is supported by the first and second uprights for moving the support member and drawing the sheet in a direction upwardly and from proximate the first side to proximate the second side of the patient support surface.
In yet another illustrative embodiment of the present invention, a proning apparatus comprises a frame, a patient support surface supported by the frame and extending between opposing first and second side edges, the patient support surface including a head end and a foot end and defining a longitudinal axis. An adjustment mechanism is supported by the frame for driving the patient support surface in vertical movement. A first upright is positioned proximate the head end and a second upright is positioned proximate the foot end. A support member is coupled to the first and second uprights and is positioned vertically above the patient support surface and positioned horizontally offset from the longitudinal axis, proximate one of the first and second side edges. A sleeve, including a center portion disposed intermediate first and second ends, is supported by the support member. At least one fastener is provided for securing the second end of the sleeve to the center portion thereof.
In a further illustrative embodiment of the present invention, a method of turning a patient from a supine position to a prone position is provided, the method comprising the steps of providing a patient support surface extending between opposing first and second side edges, the patient support surface including a head and a foot end and defining a longitudinal axis. The method further comprises the steps of providing a sleeve including an outer surface, first and second ends and a center portion intermediate the first and second ends, and supporting the first end of the sleeve vertically above the patient support surface and horizontally off-center from the longitudinal axis. The method further comprises the steps of positioning the sleeve around the patient wherein a portion of the outer surface engages the patient support surface, fastening the second end of the sleeve to the center portion thereof, lowering the patient support surface relative to the sleeve wherein the outer surface of the sleeve is in spaced relation to the patient support surface, and raising the patient support surface into contact with a portion of the outer surface of the sleeve, thereby defining a pivot point on the sleeve. A further step comprises rolling the sleeve about the pivot point thereby placing the patient in a prone position on the patient support surface.
In another illustrative embodiment of the present invention, a proning device is provided comprising a patient support surface extending between opposing first and second longitudinal side edges, a drive roller supported adjacent the first side edge, and an idler roller supported above the patient support surface. A sheet is supported by the patient support surface and includes a first sleeve portion configured to placed adjacent a chest of a patient, a second sleeve portion configured to be placed adjacent a back of a patient, and a connecting portion extending between the first portion and the drive roller. At least one fastener releasably secures the second sleeve portion to the first sleeve portion, thereby defining a sleeve for receiving the patient.
Features and advantages of the invention will become apparent to those skilled in the art upon consideration of the following detailed description of the illustrated embodiment exemplifying the best mode of carrying out the invention as presently perceived.